Image-guided surgery (“IGS”) employs pre-operative and/or intraoperative images to guide a surgeon during a surgical procedure. Laparoscopy and thoracoscopy are examples of IGS. Laparoscopy is a surgical procedure performed in the abdomen or pelvis through one or several small incisions with the aid of a camera. Thoracoscopy is a surgical procedure performed within the thoracic cavity (chest). These procedures collectively are referred to as endoscopy, which includes the use of an endoscope inserted into the body to examine the interior of the patient with minimal invasiveness. The endoscope includes a camera to acquire real time images of the operative field and may include additional instrumentation to biopsy, cut, ablate, cauterize, or otherwise manipulate a surgical target.
Another example of IGS is fluorescence IGS (“FIGS”), which uses fluorescent emission to image and guide a surgical procedure. FIGS may be used in endoscopy or open cavity surgical procedures. During FIGS, a fluorescent dye is introduced into the patient (e.g., intravenously, orally, locally) either prior to or during the surgical procedure. A particular fluorescent dye may be used, which preferentially selects cancerous cells or other anatomical structures and fluorescently labels these anatomical targets. The fluorescence image is captured by a fluorescence camera and referenced by the surgeon to identify one or more surgical targets of interest or anatomical structures. In some instances, the fluorescence image is presented with an RGB image, either adjacent to or overlaid, to provide the surgeon with additional visual information of the operative field. These RGB images can be real time images or preoperative images.
Conventional IGS systems, including those described above, present the real time images of the operative field to the surgeon on a screen, such as a liquid crystal display (“LCD”) monitor. The screen is usually placed above the patient and the surgeon has to either constantly look up and down between the surgical field and the screen, or work exclusively off the screen. Looking up is distracting, disorientating, and time consuming. This configuration is sub-optimal as it hinders acute reaction to deleterious events only visible on the screen and the surgeon must translate or guess where a fluorescence target is actually located relative to his hands and surgical instruments.
If both the RGB and fluorescence images are presented on the screen, the surgeon's perception of the operation is changed. Surgeons performing open operative procedures are used to looking at their hands directly. In addition, the position of the screen is typically optimized for viewing by the surgeon, whereas the rest of the surgical team may have a poor viewing angle or no line-of-sight to check what the surgeon is doing or anticipate his next move. In addition, none of the conventional techniques are ergonomically optimized, often resulting in neck and back pain for the surgeon.